MICHIGAN SURGERY SPECIALISTS P.C. NPI 1316939952

NPI Information

NPI: 1316939952
Provider Name: MICHIGAN SURGERY SPECIALISTS, P.C.

Doing Business As: LIFE SCAN IMAGING OF MICHIGAN

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
11012 THIRTEEN MILE ROAD
SUITE 111
WARREN, MI
ZIP 48093
Phone: (586) 558-8470
Get Directions

MICHIGAN SURGERY SPECIALISTS, P.C. is a diagnostic radiology radiology in Warren, MI. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MICHIGAN SURGERY SPECIALISTS, P.C. NPI is 1316939952. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Life Scan Imaging Of Michigan.

The provider's business location address is:

11012 THIRTEEN MILE ROAD
SUITE 111
WARREN, MI
ZIP 48093
Phone: (586) 558-8470
Fax: (586) 558-8481

The provider's authorized official is Edward F. Burke .
The authorized official title is President and has the following contact phone number (586) 751-3380.

The CLIA number assigned to this NPI record is 23D2287523 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/19/2005 and was last updated on 11/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	4301046061	MICHIGAN	No
2	2471C3401X	Radiologic Technologist	Computed Tomography	4301046061	MICHIGAN	No
3	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0E06376	MEDICARE PIN	MICHIGAN
2	300E017160	OTHER	MICHIGAN	BCBS PIN NUMBER
3	53317	OTHER		RADIATION MACHINE REGISTR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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